[Question #10119] HIV Follow Up

25 months ago

I asked a question about HIV a few months back. Since then I have had symptoms that I don’t typically experience. Because of this, I did go through testing again (4th gen and RNA qualitative) at around 130 days. Both negative. About a week+ after these tests, I developed what I believe is a bad sinus infection and started antibiotics. It’s now 2 weeks later and I’m finally starting to feel a little better. I’ve also been experiencing a dry mouth/tongue that is uncomfortable, and this concerns me the most (this started before antibiotics but has worsened). Is it possible that my most recent testing gave false negative results since these new symptoms occurred AFTER? Thank you in advance.

H. Hunter Handsfield, MD

25 months ago

Welcome back. You might have misunderstood my rather detailed (too detailed?) comments two months ago. The main point was that it is not possible to have symptoms due to HIV and have a negative HIV test. Having been tested with conclusively negative results 6 weeks (with an AgAb, i.e. 4th generation test) and against with negative RNA at 10 weeks, any symptoms from then on are not possibly caused by HIV. Your subsequent negative results at 130 days are equally conclusive. All this assume you haven't been reexposed and perhaps acquired HIV since the exposure that triggered your previous thread -- which I assume isn't the case, since you say nothing along those lines.

So unequivocally you do not have HIV. Further, the symptoms you mention are not particularly suggestive of HIV or ARS (which does not cause nasal congestion or other "sinus" symptoms). You can't go through life attributing every unexplained ache or twinge to HIV, especially when it has been proved unequivocally you do not have it. Any and all symptoms of any kind you have now or develop any time in the future, even if highly typical of HIV/AIDS, will have different causes unless and until you have new exposures that could transmit HIV. There is no such thing as false negative HIV tests this long after the last possible exposure.

Really, do your best to move on. You don't have HIV. Believe it.

HHH, MD

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25 months ago

Thank you. You are correct - there have been no other possible exposures since. I guess part of me was worried about seroconverting late, but I assume that even if that were possible, RNA tests would for sure have been positive by 130 days. I appreciate all your help. Thank you again!

H. Hunter Handsfield, MD

25 months ago

Yes, RNA testing would have picked up an infection. And glad that you apparently understand (by "even if it were possible") that "late seroconversion" never occurs with the third generation antibody tests, or with the AgAb (4th generation) blood tests. (With the exception, of course, of someone taking anti-HIV drugs e.g. for post-exposure prophylaxis, which has the potential to delay test positivity.)

Thanks for the note of appreciation. I'm glad to have helped.

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